Chap 150 Renovascular Anomalies Flashcards
1
Q
what is middle aortic syndrome?
A
abdo aortic coarctation and hypoplasia
2
Q
Where is MAS most often located
A
suprarenal then infra
3
Q
What are associated disorders with MAS?
A
Neurofibromatosis-1, (25% of abdo ao coarc have NF-1 Williams syndrom, alagille syndomr Maternal rubella Takayasu (more likely arch or DTA Umbilical artery catheterization
4
Q
What vessels have associated stenosis?
A
Splanchnic 87%
RA 62%
Usually ostial
5
Q
what are symptoms of MAS?
A
Lower extremity fatigue is infrequent Intestinal angina 6% Food aversion, weight loss HTN HA, seizure, epistaxis, visual disturances, AKI, bell’s palsy Hemorrhagic stroke, HTN encephalopathy, FTT LVH Flash pulmonary edema
6
Q
What is surgical management of MAS?
A
patch angioplasty
reimplant of visceral vessels
TA bypass
7
Q
What size graft to use for bypass at different ages?
A
8-12mm children
12-16 early ADOLESCENTS
14-20 late adolescents and adults
8
Q
When does axial growth stop?
A
age 9-10
9
Q
How and when do you repair renal artery in children?
A
after age 3
internal iliac
(SV has aneurysmal degen)
10
Q
What is the definition of HTN in children?
A
SBP or DBP >/= 95th percentile for sex age and hgt on 3 separate occasions
